Phillippi, Jelisa

Phillippi, Jelisa is an sole proprietor health care provider with primary practice located at 112 University Dr N Ste 300 , Fargo ND 58102-4661. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Phillippi, Jelisa can be contacted via phone (701) 388-9345.

Contact Information

Primary practice address
112 University Dr N Ste 300 Fargo ND 58102-4661
Phone: (701) 388-9345
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-17-28640

Profile Details

NPI number 1316475908
LBN Legal business name Phillippi, Jelisa
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 26th, 2017
Last updated Apr 21st, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316475908 NPPES
Other 1-17-28640 BEHAVIOR ANALYST CERTIFICATION BOARD

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